<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <title>Title</title>
</head>
<body>
<div class="layui-fluid">
    <fieldset class="layui-elem-field layui-field-title">
        <legend id="fieldTitle">添加新维修信息</legend>
    </fieldset>
    <form class="layui-form" action="">
        <div class="layui-form-item">
            <label class="layui-form-label">报修人</label>
            <div class="layui-input-block">
                <input type="text" name="myuserId" id="myuserId" required  lay-verify="required" placeholder="请输入内容" autocomplete="off" class="layui-input">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">联系电话</label>
            <div class="layui-input-block">
                <input type="text" name="myphone" id="myphone" required  lay-verify="required" placeholder="请输入内容" autocomplete="off" class="layui-input">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">地址</label>
            <div class="layui-input-block">
                <input type="text" name="myaddress" id="myaddress" required  lay-verify="required" placeholder="请输入内容" autocomplete="off" class="layui-input">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">标题</label>
            <div class="layui-input-block">
                <input type="text" name="mytitle" id="mytitle" required  lay-verify="required" placeholder="请输入内容" autocomplete="off" class="layui-input">
            </div>
        </div>
        <div class="layui-form-item layui-form-text">
            <label class="layui-form-label">原因</label>
            <div class="layui-input-block">
                <textarea name="myreason" id="myreason" placeholder="请输入..." class="layui-textarea"></textarea>
            </div>
        </div>
        <div class="layui-form-item addRepairInfo">
            <div class="layui-input-block">
                <a  class="layui-btn" id="repairInfo"  data-type="addRepairInfo">确认添加</a>
            </div>
        </div>
    </form>
</div>
</body>
</html>